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LIVING WITH THE LIONS CONSIDERATIONS AND CHALLENGES OF A BRITISH & IRISH LIONS TOUR

MR PRAV MATHEMA

DISCLOSURES

WRU NATIONAL MEDICAL MANAGER

WRU NATIONAL SQUAD PHYSIOTHERAPIST

WORLD RUGBY CONCUSSION WORKING GROUP MEMBER

BRITISH AND IRISH LIONS REPRESENTATIVE 09,13 & 17

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“WINNING ISN’T EVERYTHING IT’S THE ONLY THING”

RED SAUNDERS/VINCE LOMBARDI

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BEFORE DURING AFTER

BEFORE

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SCHEDULE/PLANNINGGOVERNANCE

NZRU SUPPORT CLINICAL INFORMATION (PRE-TOUR FACE TO FACE)

CONCUSSION (HIA, VIDEO AND REVIEW PROCESS)EQUIPMENT/CONSUMABLES

TRAVEL/RECOVERY PROTOCOLS

PRE-TOUR

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SCHEDULE/PLANNING

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GOVERNANCE

INSURANCE SIGN-IN AND OUT PROCESS ALL CLINICAL AND MANAGERIAL CONSENT

SECURE ELECTRONIC NOTE KEEPINGMEDICINES MANAGEMENT POLICY AND PROCEDURES

EMERGENCY ACTION PLANNING

GOVERNANCE

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NZRU SUPPORT

MATCHDAY• PERSONNEL AT EACH GAME• EXTRICATION TEAM • DEDICATED AMBULANCE • LIVE VIDEO REPLAY • MDD • EMERGENCY MEDICINE TEAM

NZRU SUPPORT

NON MATCHDAY• ACCESS TO IMAGING• CONSULTANTS • PHARMACEUTICALS• CONSUMABLES

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CONCUSSION

ALL BASELINES (SCAT AND COMPUTERISED)INJURY STRATIFICATION

APPLICATION FOR USE OF HIACONFIRMATION OF LIVE VIDEO REPLAY

CONCUSSION

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EQUIPMENT/CONSUMABLES

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53 ITEMS

FLYINGON ARRIVAL (MINDFUL OF FIRST GAME IN 72 HRS!) SOFT TISSUE THERAPISTS (ADDITIONAL SUPPPORT)ORGANISATION OF FACILITIES (ON AND OFF SITE)

TRAVEL/RECOVERY PROTOCOLS

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ACTIVE COMPONENTS – POOL/BIKE/WALK

PASSIVE COMPONENTS –SOFT TISSUE/SEQUENTIAL COMPRESSION/WEARABLE COMPRESSION/CONTRAST

BATHING/SLEEP/ NUTRITION

48 HRS PROGRAMME – MOBILITY/SOFT TISSUE

RECOVERY PROTOCOLS

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DURING

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STANDARD TRAINING DAY• 0730 meeting • 0800 screening/treatment• Morning session varied• Afternoon treatment/prep for Rugby • Rugby • Treatments post training • 2100 shop closed (but phone is on!)• Social time!

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STANDARD MATCH DAY• 0730 meeting • 0800 screening/treatment/rehab for non Match squad• Morning Rugby for non Match squad• Afternoon treatment/prep for Match squad • Treatments post training for non Match squad• Match• Post match triage• 0030-0100 shop closed/social time

OWNERSHIP & EMPOWERMENT

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MRI REPORTDigits 3,4 and 5 – Full thickness tear (partial at 5) of RCL at PIPJ

Digit 3Full thickness tear accessory radial collateral ligament at PIPJ, Volar plate

irregularity

Digit 4 Partial tear accessory radial collateral ligament at PIPJ, radial Volar plate tear

Digit 5 Partial tear accessory radial collateral ligament at PIPJ, bone marrow oedema head

of prox phalanx

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67 mins

67 mins

80 mins

69 mins

Crusaders

• ? Last Lions tour

• Best player

• Functional

• Psychologically strong

• Protect with strapping

• Off season pending

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86% for 891% in NZ21 @ 95%

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AFTER

MEDICAL AND TEAM DEBRIEFEXIT SCREENING

COMMUNICATION AND NOTES MANAGMENT TO CLUBSSTOCK CONTROL AND DISTRIBUTION

H.O.D DEBRIEF WITH BOARDCOMMENCE PLANNING FOR NEXT TOUR TO SA 2021

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LESSONS LEARNT

STAFFINGEXTRA SOFT TISSUE THERAPIST WAS POSITIVE

BUT AT THE EXPENSE OF DOCTOR CONSISTENCY IS KEY

PRE-TOUR PITCHSIDE MODULE VERY BENEFICIAL

GOVERNANCEONEROUS ? FULLY ELECTRONIC

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CONSUMABLESVERY ONEROUS ESPECIALLY FOR LOGISTICS

STREAM LINE/CENTRAL STOCK

SCHEDULINGGAME 1, 72 HRS POST ARRIVAL?

LACK OF PREPARATION TIME IS ALWAYS CHALLENGING COMMERICIAL VS PERFORMANCE DEMANDS

26 in 2 weeks

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“WINNING ISN’T EVERYTHING IT’S THE ONLY THING”

RED SAUNDERS/VINCE LOMBARDI

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Dr Eanna FalveyBob Stewart

Phil PaskAngela Rickard David Revins

Dr Ian Murphy (NZRU)

Dr James RobsonDr Gary O’DriscollRichard Wegrzyk

Clint Redhead (SARU) Dr Warren McDonald (ARU)

ACKNOWLEDGEMENTS